Bilingual Spanish RN Case Manager | Medicare Special Needs Program (SNP) | Remote | Active California RN License Required (Non-Compact)

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community.

Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Remote RN Case Manager SNP (must have RN License in California [Non-Compact]) is responsible for health care management and coordination, within the scope of licensure, for members with complex and chronic care needs. Delivers care to members utilizing the nursing process and effectively interacts with members, care givers, and other interdisciplinary team participants. Assist with closing gaps in care and resolving barriers that prevent members from attaining improved health.

Reaches out and connects with members via the telephone.

Schedule: Must be willing to work 8:00am - 5:00pm Pacific Time

GENERAL DUTIES / RESPONSIBILITIES

1.    Coordinates care by serving as a resource for the member, their family, and their physician.

2.    Ensures access to appropriate care for members with urgent or immediate needs facilitating referrals/authorizations within the benefit structure as appropriate.

3.    Completes comprehensive assessments within their scope of practice that includes assessing the member's current health status, resource utilization, past and present treatment plan, and services.

4.    Collaborates with the member, the PCP, and other members of the care team to implement a plan of care.

5.    Interfaces with Primary Care Physicians, Hospitalists, Nurse Practitioners, and specialists on the development of care management treatment plans.

6.    Provides education and self-management support based on the member’s unique learning style.

7.    Assists in problem solving with providers, claims or service issues.

8.    Works closely with delegated or contracted providers, groups, or entities to assure effective and efficient care coordination.

9.    Maintains confidentiality of all PHI in compliance with state and federal law and Alignment Healthcare Policy.

Supervisory responsibilities:

N/A

Job Requirements: